1- Investigation and management of the juvenile lame animal Flashcards
T/F cats rarely suffer from specific juvenile disease
True
What juvenile disease are rottweilers predisposed to
medial coronoid disease
What juvenile disease are border collies predisposed to
shoulder OCD
What is Perthes disease also known as
Avascular Necrosis of the Femoral Head
which breeds are predisposed to perthes dsease
The toy and small dog <6 months old.
List 3 clinical signs of Perthe’s disease
Often marked muscle atrophy (particularly the gluteal muscles)
Considerable pain on extension of the hips
Crepitus on manipulation of hips
List 4 radiographic findings of Perthes disease
Mottled appearance to femoral neck and head due to areas of lucency
A misshapen and often triangular shape to femoral head
Secondary osteoarthritic changes
Loss of muscle mass
Describe conservative management of Perthe’s disease
NSAIDs, neutraceutrical - pain management
physioltherapy
rarely successful
Describe the surgical management of Perthes disease
Femoral head and neck excision
OR
Total hip replacement
What is the prognosis of Perthes disease
After surgery - small dogs manage well on three legs therefore rehab with analgesia
At what age does Metaphyseal osteopathy tend to occur
<6 months
how do animals with Metaphyseal osteopathy tend to appear
Severe and excruciating painful swelling to the metaphyseal region of all limbs
Pyrexic and systemically unwell
List 4 clinical signs of Metaphyseal osteopathy
unable to walk
pyrexic and inappetant
Painful swellings to the distal limbs particularly the radius ulna and tibia
Associated pitting oedema over the metaphyseal regions
List 4 radiographic findings of metaphyseal osteopathy
soft tissue swelling
Ill defined lucency parallel to the physis
Periosteal lifting with mineralisation
The bridging of the physis by the inflammatory change can result in angular limb deformities
Decribe how to treat metaphyseal osteopathy
hospitalisation
Multi-modal analgesia including opiates and constant rate infusions
Corticosteroids
IV fluids
tube feeding if inappetant
what is the prognosis of metaphyseal osteopathy
good to fair
these dogs prone to further autoimmune diseases
What causes metaphyseal osteopathy
unknown aetiology
what is the most common joint affected by septic arthritis
elbow
what can polyarthritis follow in the cat
can occur with calici virus infection
describe the signalment of Craniomandibular osteopathy
small terriers
<6 months
describe Craniomandibular osteopathy-
painful condition of the mandible and occasionally long bones
soft tissue swelling and oedema to jaw
Systemically unwell and pyrexic
With chronicity becomes progressively difficult to open the mouth
List a radiographic findings seen with Craniomandibular osteopathy
Characteristic palisading (battlement-like) new bone to the mandible
The temporomandibular joint may be involved
Similar changes seen in the long bones
Describe how to treat craniomandibular osteopathy
analgesia- NSAD
corticosteroids
fluids and enteral support
What is the prognosis of craniomandibular osteopathy
This can be guarded as cases are difficult to manage and distressing for dog and owner
Long term sequelae are not uncommon including reduced opening of the mouth
making eating and subsequent endotracheal intubation difficult
describe the signalment of panosteitis
Seen in the young dog less than one year of age
GSD and males are over represented
List the clinical signs of panosteitis
Often the dog is depressed and can be pyrexic
Lameness can be severe and the dog may not weight bear
Pain on palpation of the diaphysis
List the radiographic signs of panosteitis
Loss of normal trabecula pattern particularly around the nutrient foramen
Endosteal and periosteal new bone
Can sometimes take a while for radiographic signs to occur- radiograph 2 weeks after signs
Describe how to treat panosteitis
rest and analgesia
Advise the owner that this is an episodic condition usually lasting a week and is self limiting
what is the prognosis of panosteitis
excellent
The episodes of acute lameness will become less severe and less frequent
Most cases have resolved by the time the dog is 1 year old
what causes rickets
lack of vitamin D
what occurs in rickets
The growth plates are widened due to poor or delayed mineralisation of the cartilage
what is the treatment of rickets
provision of a balanced diet containing adequate amounts of vitamin D and exposure to sunlight
what can rickets look like
nutritional secondary hyperparathyroidism (which is way more common than rickets)
Decsribe how to treat pituitary dwartfism
Treatment is with cortisol, thyroxine and progestogens
life expectancy reduced - but can last
How to angular limb deformities occur
They occur in the young growing animal when one of two or part of a growth plate closes prematurely
This arises from either trauma or bridging with periosteal bone
Define valgus abgular limb deformities
Valgus is a lateral deviation of the distal limb
what is a varus limb deformitiy
Varus is medial deviation of the distal limb
what is a femoral head and neck osteotomy
remove the entirety of the femoral head and neck
why should you always take post op radiographs after a femoral head and neck excision
to ensure you have removed enough of the femoral neck
what does angular limb deformity treatment depend on
whether the limb is still growing or not
what is the angular limb deformity CORA
centre of rotation of angulation - determines the place where corrective treatment should be performed
List 2 ways to fix angular limb deformities
closed wedge osteotomy- wedge is removed
OR
lateral open wedge osteotomy- wedge is added
